Depression: Medicate, Meditate or both?

The World Health Organization estimates that by 2020, depression will be the second largest issue in ill health worldwide. Clinical depression is defined as a persistent depressed mood or loss of interest or pleasure for at least two weeks along with a number of other physical and psychological symptoms. These could include poor sleep, loss of appetite, a sense of hopelessness and others. Studies have now found that the more often a person experiences depression, the more likely they will be to experience it again (70-80% chance of relapse for people who have suffered two or more episodes). Depression doesn’t usually occur alone and is often mixed with other issues such as anxiety and panic. So what do we do, medicate, meditate, both?

The Psychiatric field has found medications that increase the flow of certain neurotransmitters in the brain that can help relieve these feelings of depression. However, because of the relapse rate, the American Psychiatric Administration had to come up with three phases of treatment with medications, acute, continuation, and maintenance. Acute medication treatment was aimed at relieving symptoms during a depressive episode. Continuation treatment was for prescribing medication for 6 months after the episode had passed and maintenance was to prescribe for up to 3 years. So what’s the problem here? What happens after 3 years? What about the people whom medication doesn’t agree with or unable to take?

Medication was not meant to be a permanent solution to mental health issues because they don’t target the supposed causes of the episode itself, but more to help relieve symptoms for a period of time so people who are suffering could cultivate the stability and skills to support themselves moving forward. Medication can be a wonderful support; however, it’s important to also cultivate the skills to work with the potential relapse of depression moving forward. This is a more effective long term strategy.

Based on Jon Kabat-Zinn’s Mindfulness-Based Stress Reduction (MBSR) program, Zindel Segal, Mark Williams, and John Teasdale developed Mindfulness-Based Cognitive Therapy (MBCT) for depressive relapse. Teachers of this program support participants in cultivating mindfulness meditation skills to foster the ability to be more nonjudgmentally present to thoughts, feelings, and sensations in daily life. In doing this, people learn a new way of relating to their distress; rather than avoiding it they learn to approach it and live in the midst of it. This has profound consequences for what follows. When we spend our time hating and cursing our distress it’s as if we are sending negative energy into a blob of negative energy. What happens? The negativity we’re sending is food for that blob and it only grows. We don’t realize that the way we are relating to our depression, adds to it. It’s difficult to grasp this concept if we’re in the depression and that is why this approach is best when the episode is lifting or has lifted. Here is where medication can be supportive.

Working with mindfulness and meditation in this way is only one approach toward depression that is showing encouraging results in studies for preventing depressive relapse. However, there may be other ways that are supportive to you. If you are in interested in mindfullness and mental health, you may also want to check out author and blog writer Therese Borchard’s popular Mindful Monday blog every Monday in Beyond Blue.

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